NPI Code Details Logo

NPI 1962481572

NPI 1962481572 : RICHARD A. FRIEDMAN DDS : GLENDALE, NY

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1962481572
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    RICHARD A. FRIEDMAN DDS
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/12/2006
-----------------------------------------------------
    Last Update Date     |    07/08/2007
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    6503 MYRTLE AVE 
-----------------------------------------------------
    City                 |    GLENDALE
-----------------------------------------------------
    State                |    NY
-----------------------------------------------------
    Zip                  |    11385-6248
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    718-821-1453
-----------------------------------------------------
    Fax                  |    718-821-1471
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    6503 MYRTLE AVE 
-----------------------------------------------------
    City                 |    GLENDALE
-----------------------------------------------------
    State                |    NY
-----------------------------------------------------
    Zip                  |    11385-6248
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    718-821-1453
-----------------------------------------------------
    Fax                  |    718-821-1471
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    1223G0001X
-----------------------------------------------------
    Taxonomy Name        |    General Practice Dentistry
-----------------------------------------------------
    License Number       |    33946
-----------------------------------------------------
    License Number State |    NY
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.